Triorchidism with torsion

Area of Science:

• Urology
• Medical Imaging
• Reproductive Medicine

Background:

• Polyorchidism is a rare congenital anomaly, with triorchidism being the most common form.
• It is often associated with other conditions such as cryptorchidism, inguinal hernia, and testicular torsion.
• An increased risk of testicular malignancy has also been reported in cases of polyorchidism.

Observation:

• A 72-year-old male presented with acute left hemiscrotal pain.
• Physical examination revealed a tender hemiscrotum.
• Imaging studies, including ultrasound and MRI, confirmed polyorchidism with one supernumerary testis exhibiting signs of torsion and hemorrhagic necrosis.

Findings:

• The case demonstrates a rare instance of polyorchidism in an adult male.
• Ultrasound and MRI were crucial in diagnosing polyorchidism and identifying the complication of testicular torsion.
• The supernumerary testis showed features indicative of torsion and hemorrhagic necrosis.

Implications:

• This case underscores the importance of considering polyorchidism in the differential diagnosis of scrotal pain, even in older individuals.
• Advanced imaging modalities like MRI can be valuable in complex cases for detailed anatomical assessment.
• Early diagnosis and management of complications such as testicular torsion in polyorchidism are critical to prevent further damage and potential malignancy.